Category Archives: Health Care

Why Is COVID-19 Trending Down in Virginia?

by James A. Bacon

As the COVID-19 virus continues to recede in Virginia, I’ve abandoned my day-to-day coverage of the numbers, but I think it’s still worthwhile to post periodic updates. The good news for Virginia as seen in the chart above, taken from the Virginia Department of Health COVID-19 dashboard, is that the number of confirmed cases and deaths reported daily continue to decline — even as the virus flares up in California, Texas, Florida and Arizona.

To what do we attribute Virginia’s good fortune? Has Governor Ralph Northam found the sweet spot in his policy mix of emergency measures? Are Virginians just better behaved — more likely  to wear masks and maintain social distance — than the citizens of other states? Does the Old Dominion have human settlement patterns — less density, fewer elevators, less mass transit — that lend themselves to the propagation of the disease? Do we look to demographic factors such as a smaller percentage of illegal immigrants living in overcrowded housing? Or, less likely but not inconceivable, is the population on a pathway to developing herd immunity?

Readers, weigh in.


Housing Grants Just a COVID Relief Rounding Error

By Steve Haner

Will $50 million be enough? Will that get all the Virginians who have fallen behind due to COVID-19 square on their rent or mortgage payments? Or is that amount, in a relief program now fleshed out by the Northam Administration, merely a start?

There is a hint on the program’s web page, now available. “Financial assistance is a one-time payment with opportunity for renewal based on availability of funding and the household’s need for additional assistance and continued eligibility.” A Senate committee was told last week that Governor Ralph Northam is considering spending hundreds of millions more for the same purpose.

This first $50 million is just the latest way that the billions of federal dollars flowing into Virginia as COVID-19 relief will be used. Within that operation, it is a  rounding error. On June 23, primary day, the Senate Finance and Appropriations Committee met virtually to be briefed, among other things, on how the four waves of federal assistance have been or will be spent.

The usual suspects of the Capitol Hill press corps may not have been there (or to be exact, may not have been monitoring the Zoom conference.) The primary results and the Phase 3 announcement held their attention. A week later the unreported reports are still worth reviewing and links to them follow below.

Secretary of Finance Aubrey Layne, in his presentation, estimated that Virginia has received more than $28 billion in direct aid – $6.5 billion direct to the state and local governments, $14.4 billion to state businesses in the Payroll Protection Program and $7.3 billion pledged to municipal liquidity facility loans to cover revenue losses.  Continue reading

COVID-19 Update: Mixed Signals on Viral Spread

Here are three COVID-19 trends in Virginia worth watching:

  1. The seven-day moving average of the test-positive rate ticked upwards yesterday for the first time in more than a month;
  2. Hospital utilization by COVID-19 patients dipped to the lowest point since the Virginia Hospital and Healthcare Association began tracking the data in early April; and
  3. It turns out that multisystem inflammatory syndrome was not much of a thing.

Positive-test rate. The percentage of COVID-19 tests confirming the presence of the virus hit a seven-day moving average of 5.9% yesterday, based on data published today on the Virginia Department of Health (VDH) COVID-19 dashboard. That’s up from 5.8% the previous day. That doesn’t sound like much, but the seven-day moving average smooths out daily fluctuations, and it reverses what had been a steady decline since May. This number is an indicator that the viral spread in the general population, which had been retreating steadily, may start picking back up. This metric bears watching.

Hospital utilization. On the other hand, there is no indication yet that the greater numbers of infected people is translating into more trips to the hospital. Continue reading

Uh, Oh, COVID-19 Metrics No Longer Improving

Source: Virginia Department of Health COVID-19 dashboard

The bad news from recent COVID-19 statistics is that the numbers aren’t getting better. Virginia has hit a plateau in the number of confirmed cases, as seen in the chart above, which shows the seven-day moving average in the number of confirmed cases. To some degree, the tick upwards in COVID-19 cases may reflect increased testing. But it’s clear that the virus, which had been receding for a month, no longer is.

I’ve never worried overly much about the number of cases. The vast majority of cases cause no lasting harm. What matters is the number of hospitalizations and deaths. As it happens, the number of hospitalizations, which had undergone a month-long decline, also has hit a plateau, and the number of deaths has nudged noticeably higher than early June, as can be seen in the chart below. Continue reading

COVID-19: Milder than We Thought

The latest numbers from the state and hospital-association COVID-19 dashboards suggest that the coronavirus in Virginia still is retreating. The seven-day moving average of test-positive cases for COVID-19 tests continues to fall, hitting a new low of 5.8%.

Meanwhile, two measures of intensive hospital utilization have hit new lows. The number of COVID-19 patients in Intensive Care Units fell t0 219 yesterday, down from a high of 469 in early April, while the number on ventilators declined to 99, from a high of 302 in mid-April.

New research from the federal Centers for Disease Control suggest that only one in ten COVID-19 cases have been identified through testing, so the number of confirmed cases, which stands at 60,570, is likely the tip of the proverbial iceberg. If the national rate holds true here, more than 600,000 Virginians have contracted the virus. In other words, about 7% of the population has been infected. The bad news is that the virus still has a long way to run.

Here’s the good news: If that 600,000 figure holds up, and if the Virginia Department of Health’s 6,071 figure for the number of hospitalizations is reasonably accurate, it means that only 1% of the population that gets the disease ends up hospitalized for it. Given the 1,700 Virginia deaths so far, it also means that only three out of 1,000 who get the disease die from it. Continue reading

COVID Workplace Rules Endorsed, But Not Final

The Northam Administration’s Safety and Health Codes Board agreed yesterday that COVID-19 in the state’s workplaces demands an emergency state response, but the nature and exact wording of that regulation remains undecided.  If adopted, formal regulations come with the potential for heavy penalties for employers cited for failures.

Earlier versions of the key documents have already been revised by state staff, so should be reviewed again by concerned parties. The draft rules (here) and a related 200-page briefing package (here) were first made available June 12 and then revised June 23, right before Wednesday’s meeting. Further changes are likely.

A window for on-line written comments closed June 22, but more than three thousand were received, with the business community reaction overwhelmingly negative. To review the written comments already filed visit the meeting information page (here) and scroll down to a long list of documents. The massive set of online comments are on this related page on Virginia’s Regulatory Town Hall website.

The vote to proceed with something came after a contentious virtual emergency meeting where only members of the board and staff were able to speak. Three of the board’s members opposed the emergency declaration and three abstained, perhaps reflecting the broad and strong opposition the draft proposal generated from Virginia’s busines community. It will meet again to dive into the actual text soon.  Continue reading

BR’s COVID-19 Parallel Universe

By Peter Galuszka

Almost every morning, I wake up a little before dawn, make coffee, let the dog out and feed her and start reading the news.

I take The Washington Post in print along with The New York Times, Richmond Times-Dispatch, The Virginian-Pilot, NBC News, various television stations and, of course, Bacon’s Rebellion online.

Later in the morning, I check out Blue Virginia, Virginia Mercury and RVA.

When it comes to the COVID-19 pandemic, every morning I step into two different universes.

One gives me the global and national view that jumps right in and explains where we are with the virus and who and what are at risk.

The other view, that of Bacon’s Rebellion, mostly paints a very different picture. This view insists that the pandemic is exaggerated and overrated, needless regulations are being enacted by a dictatorial governor, our school system and housing trends are at risk and we should open everything up right now. Continue reading

Where Are the Other 52 Nursing Homes with Outbreaks?

by Carol J. Bova

The governor’s Long Term Care Facility Task Force list shows 179 nursing home and assisted living facilities with outbreaks of COVID-19. There are 52 more, according to the Virginia Department of Health (VDH) Outbreaks tab on the daily COVID-19 data, but no explanation why they’re missing from the Task Force list.

It took a little digging to narrow down where those facilities are located. The Task Force list can’t be downloaded or copied or sorted. But by adding its info to the CMS nursing home COVID-19 dataset and tagging each entry with the locality the Task Force used, I could compare the faciliity locations to the VDH Outbreaks Data Downloads and compile a list breaking down the number of missing outbreaks by Health District.

Alexandria – 4
Arlington – 3
Central Shenandoah – 3
Chesapeake – 1
Chesterfield – 2
Chickahominy – 2
Crater – 2
Eastern Shore – 2
Fairfax – 14 Continue reading

Nursing Homes Most at Risk from Virus are Bigger, Urban

Die, virus, die!

Three out of five of the 1,645 Virginians who have died from COVID-19 have been residents of long-term care facilities — one of the highest percentages of any state in the United States. There has been considerable speculation why. Vincent Mor, a research scientist with the Brown School of Public Health, has found that nursing-home staffing levels aren’t the issue. Neither is the source of funding, whether Medicaid or private insurance.

Mor argues that the size and location of long-term care facilities are the most decisive factors. Facilities most likely to have COVID-19 cases tend to be (1) located in larger urban areas with large populations of Hispanics and African-Americans, who are disproportionately likely to have the virus, and (2) the size of the facility, or, more specifically, the greater the number of employees coming and going.

“It’s all about the traffic,” he says in this PowerPoint presentation summarizing his research. “The bigger the building, the more people enter. … So, it’s NOT about the facility but the virus.”

I had never made these connections, and I think they are worth exploring here in Virginia. If the same pattern holds, it may influence how public health authorities prioritize the allocation of resources in the battle against the virus. Continue reading

COVID Regs Unclear, Unneeded, Contradictory

By Steve Haner

More than two dozen Virginia business associations have asked that the state’s Safety and Health Codes Board reject proposed workplace regulations to prevent COVID-19, stating they are unclear, contradictory, and not needed in light of other existing worker protections.

Some of the largest statewide associations, such as the Virginia Manufacturers Association, National Federation of Independent Business, and Virginia Retail Federation are on the list. So are some regional chambers of commerce and the Thomas Jefferson Institute for Public Policy. You can read their 13-page submission here. The conclusion reads:

“It is unreasonable to apply “one size fits all” COVID-19 regulations to all employers and employees.  Codifying guidance is not a reasonable replacement for regulation. It is confusing why after three months, the Regulations are being pursued through an emergency procedure, especially after OSHA (Occupational Safety and Health Administration) rejected the AFL-CIO’s petition for an emergency temporary standard for COVID-19 and the US Court of Appeals for the District of Columbia Circuit denied their petition for a writ of mandamus to compel OSHA to issue an Emergency Temporary Standard for Infectious Diseases.”

The draft rules (here) and a related 200-page briefing package (here) have only been available since June 12. The public comment period closes tonight, and the board is set to meet Wednesday, in a format where the public can only watch. More details are provided in a Bacon’s Rebellion post from this weekend.

Continue reading

Why Hasn’t Northam Acted Yet on the Great COVID News?

What makes Ralph run?

by James A. Bacon

A flood of COVID-19 test results were reported to the Virginia Department of Health (VDH) over the weekend — more than 45,000 tests — and the news is good. While 1,652 new cases were confirmed over Saturday and Sunday, the seven-day moving average of the percentage of people testing positive declined to 6.5%, which may be the lowest since VDH started reporting the data.

Meanwhile, we see continued declines in the number of people sick enough to warrant admittance to the hospital . The seven-day average of new hospitalizations per day now stands at 24. You have to go back to March in the earliest stages of the epidemic to find such a low number. Same story with the number of deaths.

The prevalence of the virus in the population is falling. Hospitalizations are falling. Intensive hospitalization as measured by ICU occupancy and ventilator use is falling. And deaths are falling.

Even the Virginia Mercury, an online publication with a progressive slant, is moved to explain in its COVID-19 coverage why the Northam administration isn’t opening up the economy more rapidly. After all, every criterion Governor Ralph Northam announced a month ago has been met: more testing, a falling rate of confirmed cases, and fewer hospitalization. Continue reading

Virginia Nursing Home Deaths Top 1,000

by Kerry Dougherty

Anyone here remember the very beginning of the nursing home crisis in Virginia?

Remember when we learned that a home in Henrico County, a facility where some residents reportedly had been stacked for a time like cordwood – three to a room – was in the midst of a deadly outbreak?

Last time I checked 51 residents of the Canterbury Rehabilitation and Healthcare Center had died. For a while it was the deadliest place in America.

Intelligent people demanded more information on nursing homes. They wanted to know which homes were having outbreaks, how many people were sick in each and how many people had succumbed to the virus.

The governor stubbornly refused to divulge that data even though he had it. Instead, like an oblivious doctor writing off the elderly, he claimed that privacy rights of nursing homes where people were dying trumped the right of the public to know what was going on behind closed doors.

His attorney general Mark Herring – another alum of the Virginia Democratic Blackface Club – backed him up. Continue reading

How Did VDH Miss 1,100 Suspected Cases?

by Carol J. Bova

When Governor Northam announced the release of the Virginia Health Department (VDH) COVID-19  details for specific nursing homes and assisted living facilities on June 19, he explained the reversal in policy: “It is also important that this information is released now, given inconsistent information reported at the federal level.” The governor’s Virginia Long-Term Care Task Force posted the names of facilities, the outbreak status, when it was reported to the Virginia Department of Health (VDH), and the number of COVID-19 cases and deaths.

The governor probably did not expect that federal information from The Centers For Medicare And Medicaid (CMS) COVID-19 Nursing Home Dataset would reveal that the VDH Task Force report missed 45 nursing homes that had reported more than 1,100 suspected COVID-19 cases to CMS. More than 500 suspected cases are nursing home staff members, and the others are residents. These numbers reflect only facilities not on the Task Force list and do not include any of those with an outbreak in progress.

Some of those suspected cases may have been ruled out in the past two weeks, and some may have been confirmed as COVID-19 cases, adding to the outbreak numbers. Continue reading

Sweeping COVID Workplace Regulation Proposed

By Steve Haner

The Northam Administration’s Safety and Health Codes Board will hold an emergency meeting Wednesday –- in a virtual process allowing no public interactions – to impose sweeping new regulatory mandates related to COVID-19 on Virginia workplaces.

They could take effect immediately upon Governor Ralph Northam’s signature, and will not disappear if an end is declared to the current emergencies or the threat of the disease dissipates.

The draft rules (here) and a related 200-page briefing package (here) have only been available since June 12. The window for on-line written comments closes Monday evening. The affected businesses have had some advance warning because union and employee activists have been pushing similar proposals in other states and at the federal level, often without success.

The stated goal is to prevent spread of disease in work spaces, and screening, sanitation, face coverings and social distancing are directed in detail. The focus on workplace safety follows COVID-19 outbreaks in food processing and health care settings. These proposals, however, will reach into every Virginia retail, office or manufacturing space.

To review the comments already filed (776 as of Saturday morning), or to add your own, visit the related page on Virginia’s Regulatory Town Hall website. The deadline for filing is Monday night at 11:59 p.m. The chances that the comments will be assessed and studied before the votes take place on Wednesday are slim and it appears, so far, much of the debate is focused on mask mandates. That is a minor part of this quite broad proposal.  Continue reading

COVID-19 Update: Big Move in Nursing Home Deaths

From today’s data updates…
Confirmed COVID-19 cases: 555
New hospitalizations: 53
Deaths: 16
Deaths in long-term care facilities: 55

Wait, what? How can the Virginia Department of Health report 16 news deaths overall but 55 in long-term care facilities? It appears that VDH is revising the way it reports and classifies its numbers. Whatever the reason, the total number of nursing home deaths hit the 1,000 mark yesterday. That’s out of 1,602 deaths total. The revision — adding 95 deaths to the nursing-home toll in the past two days — bumps up the percentage of total deaths associated with long-term care facilities to 62%.

Repeat after me: The COVID-19 epidemic in Virginia is largely a nursing-home epidemic.

Wise King Ralph has indicated that he will move Virginia to Phase 3 of his lockdown as early as next week, depending on…. well, that’s not entirely clear. He has indicated that he has added a new criterion: what’s happening in neighboring states. So, we’ll just have to wait and see.